How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $147.91 | Professional | None | $125.89 | $147.91 | $147.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $309.03 Typical High $371.54 | Facility | None | $239.88 | $309.03 | $371.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $177.83 Typical High $190.55 | Professional | None | $169.82 | $177.83 | $190.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | RR · Rental | $17.78 | $17.78 | $17.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | UE · Used equipment | $131.83 | $131.83 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $173.78 | Facility | None | $165.96 | $165.96 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
ConnectiCare Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
ConnectiCare Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $323.59 | Professional | None | $190.55 | $213.80 | $323.59 |
Health New England Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
United Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $199.53 | Professional | None | $114.82 | $151.36 | $199.53 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $63.10 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $25.12 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $19.05 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.59 | $14.79 | $14.79 |
Where Connecticut sits
The same service costs 2.8 times more in Montana than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Connecticut· 32nd of 51
$178
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.